HomeMy WebLinkAbout32054-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 06/27/06
No: Z-31637
THIS CERTIFIES that the building SOLAR PANELS
Location of Property: 5550 BERGEN
(HOUSE NO.)
County Tax Map No. 473889 Section 113
AVE
(STREET)
Block 7
MATTITUCK
(HAMLET)
Lot 5
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MAY 30, 2006 pursuant to which
Building Permit No. 32054-Z
dated
MAY 30, 2006
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is INSTALLATION OF SOLAR PANELS TO EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to LEO D. & MILLICENT A. RUSSELL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
1159416
09/08/03
PLUMBERS CERTIFICATION DATED
N/A
~.~--
Authorized Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 ["
APPLICATION FOR CERTIFICATE OF oecup AN (r;, '-, ~
This application must be filled in by typewriter or tnk and submitted to the Buildl11g Depa ' r I pt ~{Ie dnSwi1g: ,.:J
, '
I .
A. For new building or new use: : '. ,J
1. Final survey of property with accurate location of all buildings, property lines, streetr,and unusual natura 0
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 fonn) ,
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I % lead,
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9,1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25,00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15,00, Commercial $15.00
Old or Pre-existing Building:
Date.J-I-(!{
V __ (check one)
New Construction:
Location of Property:
5'550
House No.
15.!:7~t.r;>J/' A.,,-.
Street
h ~rr-/ ro' c",
r
.NY
Hamlet
Owner or Owners of Property:
L.,!-p /;) ; fr//~/<'~~r A,
f<V='~&a
Suffolk County Tax Map No 1000, Section _ J I 3
Subdivision
Block -.Qo "...2-.-__ Lot d 0-6
Filed Map, _____ Lot:
PennitNo. 2..9Y~3
_ Date of Penn it. Sfr?A. ~
Applicant:Je-o D.
I'ft,sS'&<<<-
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval/I:) c; 'II b
Request for:
Temporary Certificate
Final Certificate:
( check one)
Fee Submitted: $
~ M /C'~_-~..4/
Applicant Signature
~)OLf7/
~o-l- 31 ~ 3 7
"f "3~'6~ <I
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I NEW YOr:~ T~~~~;;IC~~ O~I~~P~~C';~~~~'R;~ERS I
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ LEO RUSSELL LEO RUSSELL ~
~ 5550 BERGEN AVE 5550 BERGEN AVE ~
~ MATTITUCK, NY 11952 MATTITUCK, NY 11952 ~
I Located at 5550 BERGEN AVE MATTITUCK, NY 11952 I
~ Application Number: 1159416 Certificate Number: 1159416 ~
I Section: 113 Block: 0007 Lot: 005 Building Permit: BDC: NS11 I
~ 29423 ~
~ Described as a Residential occupancy. wherein the premises electrical system consisting of ~
~ electrical devices and wiring. described below, located in/on the premises at: ~
~ Basement, solar PV system, Ontside, ~
~ ~
I was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below. was I
~ found to be in compliance therewith on the 8th Dayof September,2003. F.!I
~ Name OTY Rate Rating Circuit ~ I
~ Miscellaneous ~
~ 2-30 amp fused ale disconnects ~
~ 2-inverters(pcu) ~
~ 2-30 amp DC disconnects ~
~~- ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ ~
~ . . ~
~ ~
~ seal ~
~ ~
I 1 of 1 ~
~ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. ~
@I.@1
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
30, 2006
PERMIT NO.
32054 Z
Date MAY
permission is hereby granted to:
LEO DEAN RUSSELL & WF
5550 BERGEN AVE
MATTITUCK,NY 11952
for :
INSTALLATION OF SOLAR PANELS TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR. THIS PERMIT REPLACES BP 29423.
at premises located at
5550 BERGEN AVE
MATTITUCK
County Tax Map No. 473889 Section 113
Block 0007
Lot No. 005
pursuant to application dated MAY 30, 2006 and approved by the
Building Inspector to expire on NOVEMBER 30, 2007.
Fee $
150.00
"'-
ORIGINAL
Rev. 5/8/02
jQLo Sf :z-
TOWN OF SOUTH OLD BUilDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PlBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
~~
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DATE t ---> ~o (;,
INSPECTOR ~~
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
PERMIT NO.
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
1-/','1 2> dOs-LI
29423 Z
Date MAY
27, 2003
permission is hereby granted to:
LEO DEAN & WF RUSSELL
5550 BERGEN AVE
MATTITUCK,NY 11952
for :
INSTALLATION OF SOLAR PANELS TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR
5550 BERGEN AVE
MATTI TUCK
at premises located at
County Tax Map No. 473889 Section 113
Block 0007
Lot No. 005
pursuant to application dated MAY
23, 2003 and approved by the
Building Inspector to expire on NOVEMBER 27, 2004.
/'.,
---"-~-
Fee $
150.00
ORIGINAL
Rev. 5/8/02
A
FJELD INSPECTION REPORT DATE . COMMENTS- '- . . b>
-
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FOUNDATION (1ST) li~
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FOUNDATION (2ND) "''''
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ROUGH FRAMING & ,~ ~
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INSULATIONPERN. Y. ~ ~
STATE ENERGY CODE ..,
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Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
May 30th, 2006
Leo Russell
5550 Bergen Avenue
Mattituck, NY 11952
RE: 5550 Bergen Avenue
SCTM # 113 0007005
Dear Mr, Russell,
Please be advised that your Building Permit #29423 issued May 27th 2003 has expired.
According to the Code of the Town of South old, a Certificate of Occupancy must be
issued prior to use of the structure.
To renew your Building Permit, please submit a fee of $150.00 at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
TOwN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southoldl
PERMIT NO.
?> '"}\) 'S '-I (e-/\
d~ {23:t:
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
~d of Health
,. 3 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.5.D.E.C.
Trustees
Contact:
Examined
Approved
Disapproved ale
r;( Z- 1
~(?.1
,20~
,20-3-
Expiration
I
" / '2. 1
I
,20-1-
Q'j(
Building Inspector
Mail to:LC--o lG...-<7? 0)u Li /
ct<77D &-1.2~ev 4J C7.{flto/J
Phone:6?f7.9' -qq f3 L...
, '
ilAY 23 am ' ' ,
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a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim. the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinlmces, building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
APPLICATION FOR BUILDING PERMIT
/
L_._:~"
INSTRUCTIONS
Date M /4.\/
I
23
,20_
eY:,j() ~~ J-<.R
(Signature of applicant or name, if a corporation)
f;55o 'B~G-:6iv ,4J 11APrrrIT<&<
NY (Mailing address of applicant) 1/9<17-
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
ON/Vc-Y<.. - g Ih /deR-
Name of owner of premises Leo 'D. KJ<:;5c-z. "-
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
.tJA -5E-LF
/VA
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N4
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1. Location ofland on which proposed work will be done:
5S5o BER.~-I\J A V 111 +rTl TI/(k
House Number Street Hamlet
County Tax Map No. 1000 Section J J ~
Subdivision
Block 7
Filed Map No.
Lot 5
Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy f? ~j 0c'1I tt:.1' .
b. Intended use and occupancy ~.:f:S r Df:7v{ ~
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated cos:! ~ ?OO
Addition Alteration
OtherWork Pho!-o vo/Ie,c p~/.5>
Or\) l2cOADescription)
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
(
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specity nature and extent of each type of use.
7. Dimensions of e~sting structures, if any: Front to ~ Rear 60-
Height '2. 7 Number of Stories 2-
Dimensions of same structure with alterations or additions: Front 60
Depth 2 S-: Z 7 /' Height;> 7 .- Number of Stories
, ,
Depth ZS-- 27
Rear & D
?
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
10. Date of Purchase
100
9/70
,
.-
.-
Rear I 0(').
Depth
--
7 <"'=>O
9. Size oflol: Front
Name of Former Owner
II. Zone or use district in which premises are situated 'Z07ID~'P"I L
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO V'
13. Will lot be re-graded? YES_NO ~ill excess fill be removed from premises? YES M-- NO V
;rr71 1"'(/ tV
14. Names of Owner of premises Lc-o p, ~10LAddress5"'53'2> B~&>A;J tJI Phone No.&/2'i<.6-tt<Jez.."
Name of Architect /VA Address Phone No
Name of Contractor Ow.-v67< Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO /'
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.e. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES_NO ~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. Ifelevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
i,c:-o .D, Ii C/5~c z..( being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the Ow N Ere..
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
,
~A)~
Signature of Applicant
JOYCE M. WILKINS
Notery Public. State of New York
No. 4952246, Suffolk Cou!llY 0 /'
Term Expires June 12.-( D Co
OWNER
- .-.~~ -----._-~
,
TOWN OF SOUTHOLD PROPERTY RECORD CARD
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FORMER OWNER +- <~
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COMM. CB.
TYPE OF BUILDING
0/1,<, J;L~'r- w6~d h...,.,...
MICS. ; Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
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AGE
NEW
FARM
BUILDING CONDITION
NORMAL
BELOW
ABOVE
Value
Acre
Value Per
Acre
Tillable
House Plot
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
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Woodland
Meadowland
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DOCK
Extension
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FIN. B
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Bergen Avenue
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575 14' 10'W
100.0
5550 Bergen Ave, Mattituck, New York
Site Plan
Russell Page 1
PV Array on Roof
.
.
GRID INTER-TIE
PHOTOVOL TAlC ARRAY
LEO RUSSELL
5550 BERGEN AVENUE
IFElU{1l/C MA TTITUCK, NEw YORK
UNDERWRITERS CERTIFICATE
REQUIRED
APPROVED AS NOTED 30::' s-\
DATE:SP10' B.P.,~
FEE: /;/5?J BY: c);JiC
NOTIFY BULDING DEPARTMENT AT
115-1802 lAM TO 4PM FaR THE
Fa.I.OWNIINSPECTlClNS:
1. FOUNDATION . TWO AEOUIIlSl
FaR POURED CONCRETE
2. ROUGH . FRAMING & P'lUMlllNG
3. INSULATION
4. FINAL. CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBlE FOR
DESIGN OR CONSTRUCTION ERRORS.
~f\ 1:::>
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
A/ /"'1 SOUTHOlD TOWN ZBA
A , ~ SOUTHOlD TOWN PLANNING BOARD
"",/4 SOUTHOlD TOWN TRUSTEES
u~ N.Y.S.DEC
,
CERTIFICATION OF
NAILING & CONNECTIONS
REQUIRED.
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
FLOOD ZONE /V~
COMPLY WITH CHAPTER "46"
FLOOD DAMAGE PREVENTION
SOUTHOLD TOWN CODE.
ALL CONSTRUCTION SHALl
MEET THE REQUIREMENTS OF THE
CODES OF NEW YORK STATE.
.
300 Solar Angle Roof
Unirac-system supplied
rails & hardware
Metal Truss Nailing Plate
each side of 2X6 before
sistering with 2X12
PV Modules
8'- 1"
See framing
detail page 4
Dormer/
1 st story
No Scale
East Elevation
Russell Page 2
PV Array on Roof
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No Scale Module 8: Rack L
Russell Page 3
PV Array on Roo
Unirac-system supplied
rails 8: hardware
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PV Modules
Roofing
1/2" plywood
sheathing
Sistering of selected
rafters see page 2
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No Scale
Schott Applied Power Corporation - SunRoof RSTM
The SunRoof IS 1250, 1650, and 2500 complete with:
. The SunRoof RS 1250 - with 9 SAPC-165 modules.
The SunRoof RS 1650 - with 12 SAPC-165 modules.
The SunRoof RS 2500 - with 18 SAPC-165 modules.
. UniRac SolarMount with 108" rails, 4 "L" feet,
clamps and fasteners.
. Sunny Boy 2500U with LCD display
. Source Circuit Combiner Box
. Revenue grade digital kW hour meter
. Fusible AC Disconnect with hub
. MultiContactTM Connectors for easier installation
. AC surge arrestor
. Solar array grounding equipment
. 600V DC rated solar array
disconnect switch
. Installation Manual
SAPC-165 PHOTOVOLTAIC MODULE
SPECIFICATIONS
Cell Multi<rystal silicon sotar cells,
125mm square
No. of cells and connections 72 in series
Confiouration Nominal 24V DC OulDut
Maximum 6A}(N DC
Series fuse rating lOA
Nominal_ 16SW+I-10'l6
Dimensions 62- x 32.S" x 1.8.
WeIght 37.5Ibs.
ELECTRICAL CHARACTERISTICS
Madel SAPC-165
o n circuit volta e
MaxImum vol
Short circuit current
MaxImum current
Maximum wer
solar ceH
Madule efficiency
Vo<
Nominal
43.1
34.6
5.46
4.77
165.0
14.6
12.7
Isc
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Pm
nc
nm
s maximum per square
foot, modules, rails, wiring
and mounting hardware
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(DC) CAe) I ':lJ U~~ I 1S#.2P
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_ _ _ indicates wiring and conduit supplied by installer.
PV SYSTEM DC RATING AT STC
9-module 12-madule 18-module
SR 1250 SR 1650 SRlSOO
1 1980W 297nw
ODen-Circuit Voltage 388 VDC 517VOC 388 VOC
Max-PDwer Voltage 311 VDC 414VDC 311 VDC
Short-Circuit Current 5.46 A 5.46 A 10.92 A
Max-Power Current 4.77 A 4.77 A 9.54 A
PV System AC Rating at CEC 1230W 1640W 2460 W
Unit
V
V
A
A
W
'16
%
Conditions
SCHOTT
glass made of ideas
Irradiance:
l000W/m'
Madule
temperature:
25 C
1-800-777-6609
1-800-344-2003
www.schottapplledpower.com